Mechanical circulatory support (MCS) systems assist the heart in circulating blood in the body. A ventricular assist device (VAD) is an example of an MCS system that is used to assist one or both ventricles of the heart to circulate blood. For patients suffering from heart failure, assisting the left ventricle of the heart via a left ventricular assist device (LVAD) extending between the left ventricle and the aorta is more common, although the right ventricle may be assisted via a right ventricular assist device (RVAD) extending between the right ventricle and the pulmonary artery. Two VADs can also be used in a BiVAD configuration. Currently, VADs are commonly used for destination therapy or as a bridge to transplant option for patients with heart failure.
According to current techniques for LVAD implantation, which typically are performed on-pump (i.e., employing cardiopulmonary bypass), a hole is formed in the heart wall, typically at or near the apex of the left ventricle, and a connector or conduit is secured within or about the hole. RVAD implantation techniques, which also tend to be performed on-pump, involve forming a hole in the lateral wall of the right ventricle and securing a connector or conduit within or about the hole. After establishing a fluid tight connection between the conduit and the ventricular wall, an inlet tube of the VAD is attached to the connector or conduit, which allows blood to flow from the ventricle to a pump of the VAD. Due to the substantial risks of cardiopulmonary bypass, particularly for patients with advanced heart failure, it would be highly desirable to implant the VAD during an off-pump procedure. However, due to challenges in forming a hole in the ventricle of an active heart, reliably securing the connector or conduit in the heart wall, and reliably attaching the inlet tube of the VAD to the connector or conduit, on-pump techniques remain common for VAD implantation.
Various connectors and instruments have been developed for use in a heart wall to facilitate in vivo implantation of a VAD and its attachment to the heart. However, improved connectors, instruments, and related methods are desired for quickly, safely, and reliably implanting a VAD without the use of cardiopulmonary bypass while minimizing blood loss.